Chronic Kidney Disease Clinical Trial
Official title:
Optimised Procedure in Patients With an Acute Non-ST-segment Elevation Myocardial Infarction and Acute or Chronic Kidney Disease
Aim of the study is the determination of the ideal timepoint for the treatment of patients with acute Non-ST-segment Elevation Myocardial Infarction (NSTEMI) and an acute or chronic kidney disease (CKD) with a GRACE score < 140. It should be determine if a prompt coronary angiography or the protection of the kidneys from the used contrast agent is more important for the outcome of the patients. Additionally it will be investigated if the ischemic precondition can help to prevent heart damages.
According to international guidelines a coronary angiography has to be performed within 72h
for patients with (NSTEMI).
Patients with a GRACE score > 140 belong to the high risk group and the coronary angiography
has to be performed within 24h.
Until today for patients with a GRACE score > 140 and an acute or chronic kidney disease
(CKD) the best approach is not known even though up to 40% of all NESTMI patients belong to
this population. CKD in connection with an NSTEMI is one predictor for short and long term
mortality and serious bleeding as a complication of coronary angiography. Additionally
patient with CKD are at risk to experience a contrast agent induced aggravation of the CKD
right up to a kidney failure. The pre- and post treatment of the kidneys seem to reduce this
risk. The irrigation of the kidneys up to 48h prior coronary angiography optimises the
kidney function and buffers the aggravation of kidney function caused by fluid loss or
abstention at home.
Additionally the influence of ischemic precondition on one arm of the patient will be
evaluated in this setting. First studies give a hint that the kidneys may be protected
against the contrast agent of the following catheter examination by ischemic precondition.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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